Joseph Murray

Joseph Murray, who has died aged 93, carried out the world’s first successful
organ transplant, revolutionising the treatment of acute illness.

6:23PM GMT 27 Nov 2012

His first success in the field came in 1954, when he transplanted a kidney between identical twins. Eight years later he performed the same feat between two unrelated individuals – achievements for which in 1990 he shared the Nobel Prize in Physiology or Medicine with the bone marrow transplant pioneer Donnall Thomas.

Joseph Murray

Until 1954 attempts to transplant living tissue from one human being to another had failed due to the rejection of the transplanted tissue by the recipients’ immune systems. In the absence of immunosuppressants, transplant operations generally ended up killing the transplanted tissue, and often the patient.

Murray’s interest in transplants developed during his time in the US Army Medical Corps during the Second World War, when he was assigned to Valley Forge General Hospital in Pennsylvania, which specialised in performing reconstructive surgery on servicemen injured in battle.

One patient in particular intrigued him. Charles Woods was a 22-year-old pilot who had been badly burnt in a crash, and needed 18 months of reconstructive surgery and skin grafts. To do this doctors had to relocate small patches of skin from Woods’s own body in each operation and use skin taken from dead bodies as temporary protection on his open wounds.

Murray noticed that, instead of destroying these foreign grafts within the usual eight to 10 days, Woods’s immune system took a month. Studying his medical records, he realised that Woods’s weakened state had slowed his body’s rejection of the transplanted skin. He found another clue when the hospital’s chief of plastic surgery, who had performed skin grafts on civilians before the war, told him that he had noticed that the closer the donor and recipient were related, the slower the tissue was rejected. In 1937 a skin graft between identical twins had taken permanently. As Murray later put it in his autobiography, Surgery of the Soul (2001), “perhaps there were tricks we could learn that would one day allow us to prevent the rejection of transplanted organs” such as kidneys.

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Yet quite apart from the problem of rejection, there were huge technical problems to overcome in moving from comparatively simple skin grafts to whole organ transplants. An organ cannot survive for long without a blood supply, and nerves, tissue and blood vessels have to be painstakingly reconnected. Most surgeons thought that organ transplants were a pipe dream.

After the war, Murray moved to Peter Bent Brigham Hospital in Boston, where, practising on dogs, he pioneered new techniques involving the reconnection of nerves, tissues and blood vessels and carried out a number of successful kidney transplants on the animals. In December 1954 the opportunity to operate on a human patient presented itself in the form of Richard Herrick, a 23-year old dying of chronic nephritis who happened to have an identical twin brother who was willing to donate a kidney.

Murray prepared thoroughly, even (in an age before DNA testing) having the brothers fingerprinted by the Boston Police Department to ensure that they were identical, not fraternal, twins. He held meetings with doctors, religious leaders and lawyers to explore the ethical issues involved in subjecting a healthy human being to potentially risky surgery, and carried out a test transplant using dead bodies.

The operation, carried out on December 23, went without a hitch. Less than 90 minutes after one surgical team removed the donated kidney, Murray had connected it to Richard Herrick’s blood vessels. As the new kidney turned a healthy pink, “there were grins all around” in the operating room, Murray recalled. Richard Herrick lived for eight more years until the kidney disease recurred. His brother never felt any ill effects from his donation.

Despite the success, Murray faced enormous problems. People accused him of “playing God” and his breakthrough did not solve the problem of rejection that would affect any patient without an identical twin. In the late 1950s his team attempted several kidney transplants from unrelated donors by weakening the patients’ immune systems with radiation. But the radiation was so debilitating that two of the first three patients quickly died. The third, however, who in 1959 received a kidney transplant from a fraternal twin, plus radiation and a bone-marrow transplant to suppress his immune response, lived for 29 more years.

It was the development of immunosuppressant drugs that made real progress possible. In 1959 Murray heard about an experiment in which scientists had injected an anti-cancer drug, Imuran, into dogs to trick their immune systems into accepting a foreign protein while not preventing them from attacking other germs, and he determined to try the drug on human kidney transplant patients. But there was no guidance on how much of the drug to use and the first three patients treated with Imuran died.

By 1962, however, Murray had worked out the correct dosage and the fourth patient, a 23-year old accountant, survived after being given a kidney from an unrelated donor with the same blood type who had died on the operating table. The results were published in the New England Journal of Medicine in 1963, ushering in a new era in transplant surgery.

The son of a judge, Joseph Edward Murray was born on April 1 1919 at Milford, Massachusetts. He studied Medicine at Harvard Medical School, from which he graduated in 1943, joining the US Army Medical Corps the following year.

In 1971 Murray resigned as head of transplant surgery at Peter Bent Brigham Hospital to concentrate on plastic surgery, and over the years he treated hundreds of children and adults with severe facial deformities.

A devout Roman Catholic, Murray was a member of the Pontifical Academy of Sciences, which advises the Vatican on scientific issues. He donated his share of the Nobel Prize to Harvard Medical School and to the hospitals where he had worked.

In 1945 he married Virginia Link, who survives him with their six children